Postural instability and gait impairment during obstacle crossing in Parkinson's disease. Objective: To examine whether Parkinson's disease (PD) affects gait behavior and stability while walking over an obstacle. Design: Parallel group comparisons were completed in which participants completed 5 trials of normal walking and 5 trials of obstacle crossing while gait kinematics and kinetics were collected. Setting: University biomechanics laboratory. Participants: Individuals with PD (n=10) and age- and sex-matched healthy older adults (n=10). Interventions: Not applicable. Main Outcome Measures: Gait parameters, obstacle clearance parameters, and center of mass motion were calculated during normal walking and obstacle crossing. Results: Results revealed that decrements in gait performance in individuals with PD were amplified during obstacle crossing, suggesting that due to disease-related degradation, individuals with PD chose a more conservative strategy for obstacle crossing. Moreover, an increased duration of single limb support (18% increase), a decrease in anteroposterior range of motion (20% decrease), and an increase in mediolateral range of motion (36% increase, though not significant) coupled with the reduction in the distance between the center of pressure and center of mass (mean of 21% decrease across toe-off and heel strike) and increase in margin of stability (31% increase at toe-off and 71% increase at heel strike) may suggest that deficits in muscle strength and balance may contribute to this impairment. Conclusions: Persons with PD alter their behavior to reduce the mechanical demands and increase dynamic stability during obstacle avoidance tasks. © 2012 by the American Congress of Rehabilitation Medicine.
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